Hi! I’m Dana Obleman, creator of The Sleep Sense Program. If you’d rather read than watch, I’ve transcribed the text of this video below.

This week’s question is from Mandy. She writes:

“My friend has a 16-month-old who wakes around 12:30am every night and screams and throws herself around the crib until her mom comes in to give her a bottle. Then, she wants to play so she’ll have a tantrum and she’ll go as far as making herself vomit so that she can get out of bed and go play in the tub! Her mother feels like she has tried everything and I’m wondering if you have any suggestions?”

It doesn’t say in her note what happens at bedtime, and if you’ve watched my blog before, you know that I say it always starts with bedtime! I would encourage your friend to set up a nice structured routine with a bath, a story, and keep the bottle out of that bedtime routine completely. It sounds like she may have a little bit of a bottle association so I would either take milk right out of the bedtime situation or change over to a sippy cup. That way there is not even a loose association between waking up in the night for a bottle and going to sleep at night with a bottle.

If she is not used to going into her crib awake and falling asleep on her own, then I recommend that she does a “stay in the room” approach, where every three days you work yourself closer to the door until you’re out of the room, or just leave her and check every 10 minutes or so. In the latter case, go in and remind her it’s sleepy time, lay her back down, give her back her teddy or toy and then leave again.

The middle of the night wake up should be handled in exactly the same way. At 12:30am when she wakes up, wait a few minutes just in case it’s a night waking that she can handle on her own. If not, then a parent goes in and reminds her that it’s still night time, gives her back her teddy, lays her down and leaves again. If she’s concerned about her child actually hurting herself because she gets quite physical, then I would do the “stay in the room” approach for night waking. Just bring a chair in and sit right beside her crib.

The only thing she should say is that “It’s sleepy time” or “It’s night-night time.” Don’t get into discussions with her or respond to the tantrum. Try not to validate it in any way. Just sort of look straight ahead and say “It’s sleepy time, it’s sleep time, it’s sleep time.” She should not get out of the crib. This should just continue until she goes back to sleep.

The reason that she’s having tantrums and going so far as to throw up is because until now that’s what’s worked. Children will usually go first to whatever worked last; it’s first thing they try the next time. If having tantrum was what pushed her mother into getting her out of the crib, then she’ll continue to try having a tantrum. If vomiting worked, then I’m going to go for vomiting the next time.

It’s not unusual to see that; I’ve known a lot of toddlers who have almost become command vomiters. They’ll stick their own little finger down their throats and throw up because that’s what works to get them what they want and it seems the fastest way to get back into mommy’s bed or out of the crib or whatever the case may be. That is not something you want to be encouraging or rewarding.

Of course I’m sensitive to children who vomit and the whole experience of a child vomiting; it’s not nice or pleasant, and it’s something that I definitely like to see avoided. If she does vomit, then a parent should take her out of the crib, change her jammies and change the sheets if necessary. Do this without talking about it or giving it any kind of validation. Clean her up as quickly and quietly as you can, and then she goes back to the crib and you start again, sitting by the crib saying your mantra.

What I am saying is to remember that it is night time and it is not okay to get up or to play in the tub. It is time to sleep and that’s all that should be happening. Stay firm until eventually she gets the message and she goes back to sleep.

Now, your friend will also need to keep in mind that she doesn’t want her child to start thinking that even though she can’t get out, her parent going to sit there all night. She does need to move away. For the first three nights, she sits right by the crib just saying her mantra and then nights four, five and six she has moved back about five feet, but is still doing same thing. Nights seven, eight and nine, she should be by the door and after that she’s no longer in the room. If her child is still waking up after nine nights, she should just go in, tell her it’s sleepy time and leave again.

With toddlers, it certainly can be a little bit harder work. We all know how strong-willed toddlers are and it sounds to me like she has a very good understanding about what she needs to do to get her way so it’s definitely going to be a struggle for your friend. Unfortunately, it’s the only choice she has at this point unless she wants to continue getting up all hours of the night and attending to someone in the tub; it’s not beneficial to either your friend or the child. It really is a situation that needs to be dealt with. So, just tell her to dig deep and hang in there for a week or two and this problem should be solved.

Thanks a lot for writing in. It’s nice to see something from a concerned friend. Sleep well!